"I'm very uncomfortable with it,"
says Sonia Bélanger.
(Quebec) The Minister for Health, Sonia Bélanger, believes that it is "really inappropriate" that a funeral complex in the Montérégie offers its clients to rent its showroom to receive medical assistance in dying. "I am totally against this phenomenon that is emerging," she says, asking her teams to check if this practice complies with the law.
When she read La Presse on Friday, Ms. Bélanger experienced "significant discomfort" when she learned that the Haut-Richelieu funeral complex offered its clients medical assistance in dying on its premises. The family business is asking for approximately $700 to rent its showroom, which is set up according to the wishes of the patients. The amount disbursed is not used to pay for the care, provided by a doctor, since it is covered by health insurance. Groups such as the Quebec Association for the Right to Die with Dignity support this emerging practice.
"From the outset, I am completely against this phenomenon that arises. [...] I wonder about the urgency
of offering these services," said Minister Bélanger.
"The mission of funeral homes is to organize funerals. To pay tribute. To organize burials. All work related to cemeteries, rituals and celebrations. They have an important mission, but making connections with medical assistance in dying is a subject that requires a great deal of caution. I think it's really inappropriate at this point," she adds.
According to the minister, health facilities are fully capable of providing care, which they are already doing. While keeping in mind respect for the wishes of patients, she believes that the overcrowding of hospitals does not justify the involvement of the private sector for the time being
"We really have to be careful to mention that hospitals are congested and that for that the private sector will carve out a place of choice. I really am not here this morning. Quite the opposite. It's an important process and I think our public system has
what it takes to get it right," saysMs. Bélanger.
"I really don't want to highlight the fact that the private sector is going to carve out a place for itself [with medical assistance in dying]. I'm very uncomfortable with that," she continues.
What does the law say?In the Act respecting end-of-life care, whichMs. Bélanger is reforming these days with the study of Bill 11, it is provided that medical assistance in dying be offered "in a facility maintained by an institution, on the premises of a palliative care home or at home." The term "institution" means, within the meaning of the Act, "any institution governed by the Act respecting health services and social services that operates a local community service centre, a hospital centre or a residential and long-term care centre".
Asked if the offer of the Haut-Richelieu funeral complex complies with the law,
the Ministry of Health and Social Services (MSSS) says it is not able to answer.
"The question raised merits further reflection and consideration of elements that are not only legal, for example ethical, deontological [and] standards of practice," it says in Quebec City.
For her part, Sonia Bélanger assures that the objective of Bill 11 "is certainly not to publicize this process and even less to commercialize it."
The opposition does not want a grey areaOn the opposition side, the spokespersons for the Quebec Liberal Party (PLQ), Québec solidaire (QS) and the Parti québécois (PQ) are all surprised to learn that a funeral home offers its facilities to receive medical assistance in dying.
Christine Labrie, Member of Parliament for Québec solidaire in the riding of Sherbrooke
"You have to ask yourself the questions, especially since it's already a service that is offered in at least one place. [...] I interpret this as an illegal practice," said Solidarity MP Christine Labrie.
"It deserves a lot of collective reflection before deciding to go there. Services like these involve some form of promotion of medical assistance in dying. I am extremely uncomfortable with the situation and I would like the minister to clarify quickly [what the law says] before others start developing services like these," she asks.
Jennifer Maccarone of the Liberal Party said the government has a duty to ensure there are no grey areas in its legislation. "Our main concern is the ethical issues surrounding the commercialization and promotion of medical assistance in dying," she says.
For PQ MP Joël Arseneau, "end-of-life care, like any other health care, is not commercial goods and services" and the government must not "give a lucrative character to end-of-life care."
How far will it go?Former MP Véronique Hivon, who is described as the sponsor of the law that governed medical assistance in dying, says that the room rental offered at the Montérégie funeral home does not respect the intention of the legislator.
Former PQ MP Véronique Hivon
"Medical assistance in dying is end-of-life care. It is not a service that can be marketed. That's why the law is clear about where care can be done, which is in a health facility, in a hospice or at home," she says.
Ms. Hivon also argues that a private company that offers to rent its room to receive care "amounts to directly or indirectly promoting medical assistance in dying." According to her, "the promotion of medical assistance in dying is something we do not want to witness" and that must "at all times come from the request of a person, accompanied by a care team that knows the ins and outs [of care]".
When she read La Presse on Friday, Ms. Bélanger experienced "significant discomfort" when she learned that the Haut-Richelieu funeral complex offered its clients medical assistance in dying on its premises. The family business is asking for approximately $700 to rent its showroom, which is set up according to the wishes of the patients. The amount disbursed is not used to pay for the care, provided by a doctor, since it is covered by health insurance. Groups such as the Quebec Association for the Right to Die with Dignity support this emerging practice.
"From the outset, I am completely against this phenomenon that arises. [...] I wonder about the urgency
of offering these services," said Minister Bélanger.
"The mission of funeral homes is to organize funerals. To pay tribute. To organize burials. All work related to cemeteries, rituals and celebrations. They have an important mission, but making connections with medical assistance in dying is a subject that requires a great deal of caution. I think it's really inappropriate at this point," she adds.
According to the minister, health facilities are fully capable of providing care, which they are already doing. While keeping in mind respect for the wishes of patients, she believes that the overcrowding of hospitals does not justify the involvement of the private sector for the time being
"We really have to be careful to mention that hospitals are congested and that for that the private sector will carve out a place of choice. I really am not here this morning. Quite the opposite. It's an important process and I think our public system has
what it takes to get it right," saysMs. Bélanger.
"I really don't want to highlight the fact that the private sector is going to carve out a place for itself [with medical assistance in dying]. I'm very uncomfortable with that," she continues.
What does the law say?In the Act respecting end-of-life care, whichMs. Bélanger is reforming these days with the study of Bill 11, it is provided that medical assistance in dying be offered "in a facility maintained by an institution, on the premises of a palliative care home or at home." The term "institution" means, within the meaning of the Act, "any institution governed by the Act respecting health services and social services that operates a local community service centre, a hospital centre or a residential and long-term care centre".
Asked if the offer of the Haut-Richelieu funeral complex complies with the law,
the Ministry of Health and Social Services (MSSS) says it is not able to answer.
"The question raised merits further reflection and consideration of elements that are not only legal, for example ethical, deontological [and] standards of practice," it says in Quebec City.
For her part, Sonia Bélanger assures that the objective of Bill 11 "is certainly not to publicize this process and even less to commercialize it."
The opposition does not want a grey areaOn the opposition side, the spokespersons for the Quebec Liberal Party (PLQ), Québec solidaire (QS) and the Parti québécois (PQ) are all surprised to learn that a funeral home offers its facilities to receive medical assistance in dying.
Christine Labrie, Member of Parliament for Québec solidaire in the riding of Sherbrooke
"You have to ask yourself the questions, especially since it's already a service that is offered in at least one place. [...] I interpret this as an illegal practice," said Solidarity MP Christine Labrie.
"It deserves a lot of collective reflection before deciding to go there. Services like these involve some form of promotion of medical assistance in dying. I am extremely uncomfortable with the situation and I would like the minister to clarify quickly [what the law says] before others start developing services like these," she asks.
Jennifer Maccarone of the Liberal Party said the government has a duty to ensure there are no grey areas in its legislation. "Our main concern is the ethical issues surrounding the commercialization and promotion of medical assistance in dying," she says.
For PQ MP Joël Arseneau, "end-of-life care, like any other health care, is not commercial goods and services" and the government must not "give a lucrative character to end-of-life care."
How far will it go?Former MP Véronique Hivon, who is described as the sponsor of the law that governed medical assistance in dying, says that the room rental offered at the Montérégie funeral home does not respect the intention of the legislator.
Former PQ MP Véronique Hivon
"Medical assistance in dying is end-of-life care. It is not a service that can be marketed. That's why the law is clear about where care can be done, which is in a health facility, in a hospice or at home," she says.
Ms. Hivon also argues that a private company that offers to rent its room to receive care "amounts to directly or indirectly promoting medical assistance in dying." According to her, "the promotion of medical assistance in dying is something we do not want to witness" and that must "at all times come from the request of a person, accompanied by a care team that knows the ins and outs [of care]".
